Clinical Quality Language Specification, published by Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.5.3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cql/ and changes regularly. See the Directory of published versions
library CMS146_QDM version '2'
/*
* This take differs from the original in that it uses a function for the
* repeated timing logic between the encounter and pharyngitis.
*/
using QDM version '5.0.2'
valueset "Acute Pharyngitis": '2.16.840.1.113883.3.464.1003.102.12.1011'
valueset "Acute Tonsillitis": '2.16.840.1.113883.3.464.1003.102.12.1012'
valueset "Ambulatory/ED Visit": '2.16.840.1.113883.3.464.1003.101.12.1061'
valueset "Antibiotic Medications": '2.16.840.1.113883.3.464.1003.196.12.1001'
valueset "Group A Streptococcus Test": '2.16.840.1.113883.3.464.1003.198.12.1012'
parameter MeasurementPeriod Interval<DateTime>
context Patient
define "InDemographic":
AgeInYearsAt(start of MeasurementPeriod) >= 2 and AgeInYearsAt(start of MeasurementPeriod) < 18
define "Pharyngitis":
["Diagnosis": "Acute Pharyngitis"] union ["Diagnosis": "Acute Tonsillitis"]
define "Antibiotics":
["Medication, Order": "Antibiotic Medications"] M
define function isRelated(P "Diagnosis", E "EncounterPerformed") :
P.prevalencePeriod includes E.relevantPeriod
or P.prevalencePeriod starts during E.relevantPeriod
define "MeasurementPeriodEncounters":
["Encounter, Performed": "Ambulatory/ED Visit"] E
where "InDemographic"
and E.relevantPeriod during MeasurementPeriod
define "PharyngitisEncounters":
"MeasurementPeriodEncounters" E
with "Pharyngitis" P such that isRelated(P, E)
with "Antibiotics" A such that A.authorDatetime 3 days or less after start of E.relevantPeriod
define "PharyngitisWithPriorAntibiotics":
"Pharyngitis" P
with "Antibiotics" A such that A.authorDatetime 30 days or less before start of P.prevalencePeriod
define "ExcludedEncounters":
"PharyngitisEncounters" E
with "PharyngitisWithPriorAntibiotics" P such that isRelated(P, E)
define "StrepTestEncounters":
"PharyngitisEncounters" E
with ["Laboratory Test, Performed": "Group A Streptococcus Test"] T
such that T."result" is not null
and T.relevantPeriod starts within 3 days of E.relevantPeriod
define "IPPCount":
Count("PharyngitisEncounters")
define "DenominatorCount":
"IPPCount"
define "DenominatorExclusionsCount":
Count("ExcludedEncounters")
define "NumeratorCount":
Count("StrepTestEncounters" except "ExcludedEncounters")